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DSH290019H CARSON TAHOE REGIONAL HEALTHCARE (Active)
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Main Details
Name
CARSON TAHOE REGIONAL HEALTHCARE
Subdivision Name
CARSON TAHOE REGIONAL MEDICAL CENTE - GREAT BASIN IMAGING
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH290019H
Medicare Provider Number
290019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/15/2024
Participating Start Date
10/1/2024
Participating Approval Date
9/3/2024
Last Recertification Date
Contacts
Authorizing Official
Carson Tahoe Regional Health
Katie Kucera, Chief Financial Officer
(775) 445-8000 Ext: 5543
Primary Contact
Carson Tahoe Regional Health
Andrew P. Batiza, 340B Coordinator
(775) 445-8653
Addresses
Street Address
2874 N CARSON ST
STE 300
CARSON CITY, NV 89706-1683
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (10/01/2022) until terminated effective date: (10/01/2023); reinstatement effective date: (10/1/2024)
09/03/2024
June 2025
June 2025
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